La. Admin. Code tit. 46 § XLVII-3707

Current through Register Vol. 50, No. 9, September 20, 2024

Section XLVII-3707 - Peripherally Inserted Central Catheter (PICC) Insertion and Removal

A. Definition

PICC Line-peripherally inserted central catheters (PICCs) are venous devices used to administer all types of intravenous medications and solutions. PICCs are soft, flexible catheters.

B. Registered nurses may insert, secure and remove central catheters through peripheral venous sites provided that the following conditions are met:

1. documentation of satisfactory completion of a minimum of four hours of study in an appropriate instructional program and verification of employment in a supervised clinical practice on file with the employer;

2. catheter placement is pursuant to a physician or other qualified prescriber's order for the procedure;

3. the procedure is performed according to appropriately established policy and procedure of the health care facility, employing agency and/or physician's office;

4. in view of the proliferation of various catheter products available for placement, the registered nurse must be knowledgeable about the manufacturer's suggestions and precautions concerning the specific catheter product utilized, and should review product information on a frequent basis; and

5. prior to initiation of therapy, catheter tip placement must be determined by a physician or an advanced practice registered nurse with the following provisos.

a. The procedure of verifying catheter tip placement by an APRN is a written established institutional/facility policy which:

i. delineates that the APRN must be credentialed by the agency prior to performing the procedure;

ii. delineates the specific procedure in the clinical privileges of the individual APRN;

iii. verifies competencies initially and at regular intervals through methods including but not limited to direct observation;

iv. provides that the final verification of catheter tip placement performed via radiographic methods be provided by a physician; and

v. requires and documents evidence of formal didactic educational preparation and clinical experiences of the APRN to perform the procedure.

C. In order for a registered nurse to be authorized by the board under this Section, the instructional program shall include the following courses of study:

1. for nurses performing duties to include insertion of PICC lines:

a. anatomy and physiology of circulation and fluid balance;

b. indications and contradictions for PICC placement;

c. complications and management techniques to include potential adverse reactions;

d. techniques for placement of PICC lines may include ultrasound techniques;

e. techniques for placement of PICC line placement and removal; and

f. nursing responsibilities;

2. for nurses performing duties that would include management and monitoring of PICC lines:

a. anatomy and physiology of circulation and fluid balance;

b. indications and contraindications for PICC placement;

c. complications and management techniques to include potential adverse reactions; and

d. nursing responsibilities;

3. for nursing performing the duties of PICC line removal:

a. techniques for PICC line removal;

b. complications and management techniques to include potential adverse reactions; and

c. nursing responsibilities.

La. Admin. Code tit. 46, § XLVII-3707

Promulgated by the Department of Health and Hospitals, Board of Nursing, LR 36:64 (January 2010), amended LR 39:501 (March 2013).

AUTHORITY NOTE: Promulgated in accordance with R.S. 37:918.